| 包哲元,张文龙,冯柏涵,等.不同内固定方式固定Herscovici B型及C型内踝骨折的有限元分析.骨科,2024,15(2): 125-132. |
| 不同内固定方式固定Herscovici B型及C型内踝骨折的有限元分析 |
| Finite Element Analysis of Different Internal Fixation Methods for Herscovici Type B and C Medial Malleolus Fractures |
| 投稿时间：2023-12-15 |
| DOI：10.3969/j.issn.1674-8573.2024.02.006 |
| 中文关键词: 内踝骨折 有限元分析 角度 全螺纹螺钉 半螺纹螺钉 克氏针张力带 |
| 英文关键词: Medial malleolus fracture Finite element analysis Angle Fully threaded screw Half threaded screw Kirschner wire tension band |
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| 中文摘要: |
| 目的 应用有限元分析法，探究不同内固定方式及不同置入角度固定Herscovici B型及C型内踝骨折的生物力学稳定性。方法 应用Mimics 19.0软件建立胫骨远端三维模型，通过Geomagic Studio 2013及SolidWorks 2017软件对模型进行加工以及内置物的装配，建立Herscovici B型及C型内踝骨折以及全螺纹螺钉、半螺纹螺钉、克氏针张力带三种不同内固定模型。运用ANSYS Workbench 17.0有限元分析软件对模型进行参数设定以及载荷施加，分析骨折端应力、位移及内置物应力及位移等情况，并进行统计分析。结果 对于Herscovici B型骨折，在相同载荷下，三种内固定方式均在与骨折线成130°~140°角范围内的置入角度下最稳定（P＜0.05）；载荷及内置物置入角度都相同的条件下，全螺纹螺钉组相对于其他两种内固定方式更稳定。对于Herscovici C型骨折，在相同载荷下，三种内固定方式均在与骨折线成130°~140°角范围内的置入角度下最稳定（P＜0.05）；载荷及内置物置入角度都相同的条件下，全螺纹螺钉组相对于其他两种内固定方式更稳定。结论 针对Herscovici B型及C型骨折，全螺纹螺钉相较于半螺纹螺钉及克氏针张力带稳定性更佳，且置入角度为与骨折线成130°~140°角范围内的稳定效果更好。这对临床治疗Herscovici B型及C型内踝骨折具有参考意义。 |
| 英文摘要: |
| Objective To explore the biomechanical stability of different internal fixation methods and different implantation angles for Herscovici B and C medial malleolus fractures by finite element analysis. Methods The three-dimensional models of distal tibia were established by Mimics 19.0 software, and the models were processed and assembled with internal fixators by using Geomagic Studio 2013 and SolidWorks 2017 software to establish Herscovici B-type and C-type ankle fractures, as well as three different internal fixation models, including fully threaded screws, semi threaded screws, and Kirschner wire tension bands. The ANSYS Workbench 17.0 finite element analysis software was used to set parameters and apply loads to the models, and the stress, displacement of fracture ends, stress and displacement of internal fixators were analyzed. SPSS 26.0 software was used for statistical analysis. Results For Herscovici B fracture, under the same load, the three internal fixation methods were most stable at the angle of internal fixation insertion ranging from 130° to 140° with respect to the fracture line (P＜0.05); Under the same conditions of load and internal fixator insertion angle, the fully threaded screw group was more stable than the other two internal fixation methods. For Herscovici C fracture, under the same load, the three internal fixation methods were most stable at the angle of internal fixation insertion ranging from 130° to 140° with respect to the fracture line (P＜0.05); Under the same conditions of load and internal fixator insertion angle, the fully threaded screw group was more stable than the other two internal fixation methods. Conclusion For Herscovici B and C fractures, the stability of fully threaded screw is better than that of half threaded screw and Kirschner wire tension band, and the effect of stability is better when the insertion angle is within the range of 130°-140° with respect to the fracture line. This has reference value for the clinical treatment of Herscovici B and C medial malleolus fractures. |
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